Middle cerebral artery Doppler

Brennand, Janet

doi:10.1002/j.2205-0140.2009.tb00058.x

Cited by 9 publications

(1 citation statement)

References 39 publications

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“…Where PSV is the peak systolic velocity, EDV is the enddiastolic velocity, and TAV is the time-averaged (mean) velocity. For this purpose, the middle cerebral artery (MCA) has been consistently used as the vessel of choice for its accessibility and sensitivity to hypoxemia (79).…”

Section: Impaired Cerebral Substrate Delivery and Brain Sparing Response In Chdmentioning

confidence: 99%

Fetal brain issues in congenital heart disease

et al. 2021

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Following the improvements in the clinical management of patients with congenital heart disease (CHD) and their increased survival, neurodevelopmental outcome has become an emerging priority in pediatric cardiology. Large-scale efforts have been made to protect the brain during the postnatal, surgical, and postoperative period; however, the presence of brain immaturity and injury at birth suggests in utero and peripartum disturbances. Over the past decade, there has been considerable interest and investigations on fetal brain growth in the setting of CHD. Advancements in fetal brain imaging have identified abnormal brain development in fetuses with CHD from the macrostructural (brain volumes and cortical folding) down to the microstructural (biochemistry and water diffusivity) scale, with more severe forms of CHD showing worse disturbances and brain abnormalities starting as early as the first trimester. Anomalies in common genetic developmental pathways and diminished cerebral substrate delivery secondary to altered cardiovascular physiology are the forefront hypotheses, but other factors such as impaired placental function and maternal psychological stress have surfaced as important contributors to fetal brain immaturity in CHD.The characterization and timing of fetal brain disturbances and their associated mechanisms are important steps for determining preventative prenatal interventions, which may provide a stronger foundation for the developing brain during childhood.

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Section: Impaired Cerebral Substrate Delivery and Brain Sparing Response In Chdmentioning

confidence: 99%

Fetal brain issues in congenital heart disease

et al. 2021

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Second systolic peak in fetal middle cerebral artery Doppler after intrauterine transfusion

Vonzun

Ochsenbein‐Kölble

Balsyte

et al. 2022

Arch Gynecol Obstet

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Objective To evaluate functional relationship between fetal circulatory response to intrauterine transfusion (IUT) as a circulatory challenge and appearance of second systolic peak (P2) in middle cerebral artery (MCA) based on hemodynamic principles. Methods According to the concept of pulse wave (PW) propagation and reflection in adults, PWs arrive twice at cerebral circulation, as primary wave caused by left ventricle ejection and secondary after reflection in peripheral arteries. Thus adults show a biphasic contour of systolic blood flow in cerebral arteries. Similar waveforms may appear in fetal MCA-Doppler, as a response to IUT as a circulatory challenge. This is a proof-of-principle study, applying classical hemodynamic principles to fetal circulation. Accordingly, appearance of MCA-P2 may indicate vasoconstriction with increased PW reflection and timing of P2(Δt) should agree with the additional PW travel time down to reflection and return (Tr). To test this agreement, we searched our database for IUTs performed for severe fetal anemia, and compared Δt, obtained by Doppler, with Tr, obtained by hemodynamic calculation using human fetal data. Level of agreement was assessed using Bland–Altman-Plots. Results We identified 21 fetuses with adequate Doppler quality for Δt evaluation. In four cases (19%) MCA-P2 was observed before the intervention, and in 17 interventions (81%) thereafter; a highly significant association between IUT and P2 appearance (p < 0.001). In these 17 interventions good agreement of P2 timing was found between Doppler assessment: Δt = 80 ± 8 ms, and hemodynamic calculation: Tr = 76 ± 4 ms. Conclusion P2 appearance in fetal MCA-Doppler seems to indicate PW reflection due to increased vasoconstriction after IUT. Thus hemodynamic considerations might enable Doppler monitoring of fetal vasoconstriction.

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Using Doppler ultrasound to assess fetal cardiac function and pregnancy outcomes in obstetric antiphospholipid syndrome pregnancies: a case–control study

Wang,

et al. 2024

Arch Gynecol Obstet

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Middle cerebral artery Doppler

Cited by 9 publications

References 39 publications

Fetal brain issues in congenital heart disease

Fetal brain issues in congenital heart disease

Second systolic peak in fetal middle cerebral artery Doppler after intrauterine transfusion

Using Doppler ultrasound to assess fetal cardiac function and pregnancy outcomes in obstetric antiphospholipid syndrome pregnancies: a case–control study

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